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The Effect of Mandala Coloring on Anxiety, Stress, Hemodynamic Parameters, and Cortisol Levels in Patients Undergoing
Didem Kandemir1, Zeynep Temiz2, Semiha Öztürk Akın3
1Surgical Receiving Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom.
Purpose:
To evaluate the effect of mindfulness-based mandala coloring implemented before coronary angiography on patients' anxiety, stress, hemodynamic parameters, and plasma cortisol levels.
Design:
Single-blind, two-group, randomized controlled trial.
Methods:
The study was conducted in the coronary intensive care unit of a state hospital between June 2023 and October 2024. A total of 90 patients (45 mandala coloring and 45 control) participated in the study. Data were collected using the State Anxiety Inventory, the Distress Thermometer, and the Hemodynamic Variables and Cortisol Level Monitoring Form.
Findings:
The mandala coloring group exhibited higher stress and anxiety levels at initial admission to the unit (T0); these levels were significantly reduced at 15 minutes after mandala coloring intervention before angiography (T1) and 30 minutes after transfer to the ward following angiography (T2) (P < .05). No significant differences were observed between the mandala coloring and control groups in terms of hemodynamic parameters across all time points (P > .05). Furthermore, cortisol levels in the mandala coloring group were significantly decreased after angiography (P < .05).
Conclusions:
This study is significant as it is the first to demonstrate that a mindfulness-based mandala coloring is an effective nonpharmacological intervention for reducing patients' perceived levels of anxiety and stress before angiography, as well as for decreasing physiological stress markers such as plasma cortisol levels.
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